ArticleInternational journal of surgery (London, England)2024
Endovascular treatment versus standard medical treatment in patients with established large infarct: a cohort study.
Article in International journal of surgery (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Endovascular Treatment for Patients Aged ≥80 Years with Large Ischemic Stroke.Clinical interventions in aging · 2026Trial
- Association between the triglyceride-glucose index and collateral status in ischemic stroke patients undergoing endovascular therapy.Clinical neuroradiology · 2026Article
- Educational value of remote live-streamed training in endovascular thrombectomy: dose-response and mediation analysis.Journal of neurointerventional surgery · 2026Article
- Admission Phenotype Clarifies the Apparent Prognostic Contrast Between TOAST Etiologic Subtypes in Large-Core Anterior-Circulation Large-Vessel Occlusion.CNS neuroscience & therapeutics · 2026Article
- Procedure time and 90-day outcomes after endovascular thrombectomy for large-core stroke.European stroke journal · 2026Observational
- Impact of age on clinical outcomes after endovascular therapy for large ischemic stroke.Journal of neurology · 2026Article
- CTA imaging characteristics and endovascular therapy effect in patients with large ischemic stroke: a prospective cohort study.Neurological research and practice · 2026Article
- Clinical Benefit of Thrombectomy in Large-Core Infarction Patients Is Mediated by Malignant Cerebral Edema Reduction.Journal of the American Heart Association · 2026Article
- Combined assessment of ASPECTS and collateral status predict outcomes after endovascular therapy in patients with large ischemic stroke.Frontiers in neurology · 2026Observational
- Association between admission blood urea nitrogen and clinical outcomes in patients with large ischemic stroke undergoing endovascular treatment.Frontiers in neurology · 2026Article
- Predictors of futile recanalization after endovascular therapy in anterior circulation stroke with large core infarction.Frontiers in neurology · 2025Article
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Authors and funding
25 authors.
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Abstract
backgroundPrevious trials confirmed the benefit of endovascular treatment (EVT) in acute large core stroke, but the effect of EVT on outcomes in these patients based on noncontrast computed tomography (NCCT) in real-world clinical practice was unclear. The aim of this study was to explore the effect of EVT versus standard medical treatment (SMT) in patients with large ischemic core stroke defined as Alberta Stroke Program Early CT Score (ASPECTS) ≤5 based on NCCT alone. MATERIALS AND
methodsPatients with acute large core stroke at 38 Chinese centers between November 2021 and February 2023 were reviewed from a prospectively maintained database. The primary outcome was favorable functional outcome [modified Rankin Scale score (mRS), 0-3] at 90 days. Safety outcomes included 48 h symptomatic intracerebral hemorrhage (sICH) and 90-day mortality.
resultsOf 745 eligible patients recruited at 38 stroke centers between November 2021 and February 2023, 490 were treated with EVT+SMT and 255 with SMT alone. One hundred and eighty-one (36.9%) in the EVT group achieved favorable functional independence versus 48 (18.8%) treated with SMT only [adjusted risk ratio (RR), 1.86; 95% CI: 1.43-2.42, P <0.001; adjusted risk difference (RD), 13.77; 95% CI: 7.40-20.15, P <0.001]. The proportion of sICH was significantly higher in patients undergoing EVT (13.3 vs. 2.4%; adjusted RR, 5.17; 95% CI: 2.17-12.32, P <0.001; adjusted RD, 10.10; 95% CI: 6.12-14.09, P <0.001). No significant difference of mortality between the groups was observed (41.8 vs. 49.0%; adjusted RR, 0.91; 95% CI: 0.77-1.07, P =0.24; adjusted RD, -5.91; 95% CI: -12.91-1.09, P =0.1).
conclusionAmong patients with acute large core stroke based on NCCT in real-world, EVT is associated with better functional outcomes at 90 days despite of higher risk of sICH. Rates of procedure-related complications were relatively higher in the EVT+SMT group.
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